Secondary Insurance Question

So I'm almost finished with everything I have to do before I send off for insurance approval. And things are going well and it looks like I shouldn't have any problem BUT yesterday, I received notice that I had been approved for government health insurance (Medicaid) so now apparently I have that as a secondary insurance. Medicaid has much more strict requirements for the surgery. So my question is, if you have 2 different insurances do they both have to approve you in order for you to get the surgery or do you just have to get approval from the Primary insurance company. If anyone has any knowledge or experience with this your input would be greatly appreciated.

Hi,  

There are probably different ways this can work (or not work) but I'll tell you my experience. 

I am dual insured.  My primary is thru my work, the secondary is thru my husband's. In my experience, you just need approval from the primary and then the secondary goes along with it.  

For my weight loss surgery, both insurances typically require an authorization process.  But, since I was dual insured, I only needed to satisfy my primary insurance's requirements.  The secondary picked up their usual portion of the bills even tho I didn't give them any information about the surgery ahead of time.  

In hindsight, I should have checked with the secondary before the surgery because I would have been super bummed if they didn't pick up their part because I didn't pick up the phone to double check that I understood the process.  

Good luck! 

~Shel

Thanks Shel,

I didn't expect to qualify for the second insurance so I was expecting to pay out of pocket for what my primary didn't cover. So this is really just a helpful bonus that will hopefully save me some money. I just know that the secondary's approval process for WLS is nearly impossible in my situation so I wanted to make sure I wasn't going to have to jump through any more hoops when I'm getting so close.

I don't know for sure but I think Medicaid is always considered primary if you have a second policy. 

It is possible that you will have to meet Medicaids policy also. 

I don't have any answers for your questions but there are three phone calls to make, both insurance companies and the Dr. office.  Between the three of them you should be able to get your questions answered. Hope it all works out to your benefit.

I know thats the logical thing to do, and I will first thing Monday morning. But the card came in Friday after 5 and the possibilities were so overwhelming I thought I would ask here in hopes of an answer, instead of having to wait the weekend to find out.